Is immigration good for the health of older Americans?

When we talk about immigration, we tend to focus on wages, employment, border politics, and, more recently, ICE crackdowns. But a new working paper from the National Bureau of Economic Research suggests immigrants may also be shaping the health — and the mortality rates — of older Americans.

For more, “Marketplace Morning Report” host David Brancaccio spoke with Brian McGarry, one of the co-authors of the paper and a faculty research fellow at NBER. The following is an edited transcript of their conversation.

David Brancaccio: Help me understand this connection, this equation between immigration policy and not dying prematurely. What did you find?

Brian McGarry: Yeah, so what we find is that roughly a 25% increase in the flow of immigrants into the U.S., we estimate would prevent about 5,000 deaths among our nation's older adults. So, these are 65 and older at the start of our study. The motivation for this study really comes from the fact that our health care system disproportionately relies on immigrant workers.

Brancaccio: And so, the more immigration that's allowed in that population of immigrants, there's going to be a subset who are health care workers, and that affects outcomes?

McGarry: So, we find in the paper that for roughly about 1,000 new immigrants coming into the U.S. leads to about 173 more health care workers, both foreign and domestic. So, often a concern with immigration is that the immigrants are sort of displacing domestic workers. In our case, we find actually some slight what we call “crowd-in,” where, with greater capacity of immigrant workers, many of them who may be support staff in the health care system — nurses, aides — may actually create jobs that allow hiring of other domestic workers.

Brancaccio: And so, it's not necessarily bringing in people who are sort of CEO level. You're talking about more rank-and-file health care workers.

McGarry: Absolutely, and that's a really important point. In this paper, a lot of the effect seems to come through keeping older adults out of nursing homes, and for those who are in the nursing homes, potentially improving the quality of the care delivered. And so, a lot of the care that's delivered is done by what we refer to as “low-skilled,” not to imply that they don't have really great skills, but they don't require the same levels of education. And so that turns out to be a really important part of the health effects.

Brancaccio: And it must be defined as like premature deaths, right? I mean, we all die in the end, right?

McGarry: Yes, that's right. So, what we're doing here is prolonging life for older adults. Nursing homes are inherently congregate living settings. Those are sort of ripe for infectious disease outbreaks. But we also know that for the most part, older adults prefer to age in place and to age at home. So, we're showing the sort of prolonged life benefits, but there's reason to suspect that there's also some quality-of-life benefits at play here as well, by helping older adults age in place and stay in their preferred settings.